Common Respiratory Infections in Children Admitted to Aboozar Children's Hospital in Ahvaz City in the First Semester 2021: Frequency, Risk Factors and Clinical Subgroups

Document Type : Original Article

Authors

1 Emergency Medicine Department,, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

10.61186/jsmj.22.2.4

Abstract

Background and Objectives The aim of this study is to determine the prevalence of respiratory infections in children admitted to Aboozar Children's Hospital in Ahvaz and the associated risk factors. Subjects and Methods A total of147 children aged 12 years and below admitted to the emergency department were selected for this case-control study, including 96 children with respiratory infections and 51 children without respiratory and/or digestive infections as a control group. Their demographic, clinical, and laboratory data were recorded and statistically compared between the two groups. Results Pneumonia (80.2%), especially pneumonia caused by coronavirus 2019, was the most common type of respiratory infection in children. The prevalence and risk of respiratory complications were significantly higher in boys than in girls (p=0.003). The mean age of children with respiratory infections was also higher than that of the control group (p<0.05). In addition, high body mass index, underlying diseases, low birth weight, reduced or no breastfeeding, a family with many children, parental smoking and air pollution were significantly associated with the high risk of infection (p<0.05). Compared to the control group, the children with respiratory infections had lower levels of red blood cells and lymphocytes, but higher levels of neutrophils (p<0.05). Conclusion Knowledge of diagnostic markers and possible risk factors for respiratory infections in children at the beginning of admission to the ward can play a key role in timely diagnosis and treatment of patients.

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[1] The UN Inter-agency Group for Child Mortality Estimation. Levels & Trends in Child Mortality: Report 2014. New York. UNICEF. 2014.
[2] Organization WH, UNICEF. Ending preventable child deaths from pneumonia and diarrhoea by 2025: the integrated global action plan for pneumonia and diarrhoea (GAPPD). 2013.
[3] Nair H, Simoes EA, Rudan I, Gessner BD, Azziz-Baumgartner E, Zhang JS, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet. 2013;381(9875):1380-1390. [DOI: 10.1016/S0140-6736(12) 61901-1] [PMID] [PMCID]
[4] Murarkar S, Gothankar J, Doke P, Dhumale G, Pore PD, Lalwani S, et al. Prevalence of the Acute Respiratory Infections and Associated Factors in the Rural Areas and Urban Slum Areas of Western Maharashtra, India: A Community-Based Cross-Sectional Study. Front Public Health. 2021;9:723807. [DOI: 10.3389/fpubh.2021.723807] [PMID] [PMCID]
[5] Man WH, van Houten MA, Mérelle ME, Vlieger AM, Chu MLJN, Jansen NJG, et al. Bacterial and viral respiratory tract microbiota and host characteristics in children with lower respiratory tract infections: a matched case-control study. Lancet Respir Med. 2019;7(5):417-426. [DOI: 10.1016/S2213-2600(18)30449-1] [PMID] [PMCID]
[6] May Loo, MD Chapter 60. Upper Respiratory Tract Infection. Integrative Medicine for Children. 2009:450–5. [DOI: 10.1016/ B978-141602299-2.10060-X] [PMID]
[7] Moghadami M. A Narrative Review of Influenza: A Seasonal and Pandemic Disease. Iran J Med Sci. 2017;42(1):2-13. [PMID]
[8] Zhou JY, Peng Y, Peng XY, Gao HC, Sun YP, Xie LY, et al. Human bocavirus and human metapneumovirus in hospitalized children with lower respiratory tract illness in Changsha, China. Influenza Other Respir Viruses. 2018;12(2):279-286. [DOI: 10. 1111/irv.12535] [PMID]
[9] Chen J, Hu P, Zhou T, Zheng T, Zhou L, Jiang C, et al. Epidemiology and clinical characteristics of acute respiratory tract infections among hospitalized infants and young children in Chengdu, West China, 2009-2014. BMC Pediatr. 2018;18(1):216. [DOI: 10.1186/s12887-018-1203-y] [PMID] [PMCID]
[10] Han X, Xu P, Wang H, Mao J, Ye Q. Incident changes in the prevalence of respiratory virus among children during COVID-19 pandemic in Hangzhou, China. J Infect. 2022;84(4):579-613. [DOI: 10.1016/j.jinf.2022.01.007] [PMID] [PMCID]
[11] Hai-Feng LI, Yan Z, Pei-Gang J, Hong-Xing J. Risk factors for recurrent respiratory infections in preschool children in china. Iran J Pediatr. 2014;24(1):14-22. [PMID]
[12] Sutriana VN, Sitaresmi MN, Wahab A. Risk factors for childhood pneumonia: a case-control study in a high prevalence area in Indonesia. Clin Exp Pediatr. 2021;64(11):588-595. [DOI: 10.3345/ cep.2020.00339] [PMID] [PMCID]
[13] Koenen MH, van Montfrans JM, Sanders EAM, Bogaert D, Verhagen LM. Immunoglobulin A deficiency in children, an undervalued clinical issue. Clin Immunol. 2019;209:108293. [DOI: 10.1016/j.clim.2019.108293] [PMID]
[14] Han Q, Wen X, Wang L, Han X, Shen Y, Cao J, et al. Role of hematological parameters in the diagnosis of influenza virus infection in patients with respiratory tract infection symptoms. J Clin Lab Anal. 2020;34(5):e23191. [DOI: 10.1002/jcla.23191] [PMID]
[15] Fagbo SF, Garbati MA, Hasan R, AlShahrani D, Al-Shehri M, AlFawaz T, et al. Acute viral respiratory infections among children in MERS-endemic Riyadh, Saudi Arabia, 2012-2013. J Med Virol. 2017;89(2):195-201. [DOI: 10.1002/jmv.24632] [PMID]
[16] WHO. World health organization. pneumonia. 2019.
[17] Harris M, Clark J, Coote N, Fletcher P, Harnden A, McKean M, et al. British Thoracic Society Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in children: update 2011. Thorax. 2011;66(2):1-23. [DOI: 10.1136/thoraxjnl-2011-200598] [PMID]
[18] Yavarian J, Zahra Shafiei Jandaghi N, Rahimi-Foroushani A, Shadab A, Ghamarchehreh M, et al. Human Metapneumovirus and Influenza Viruses in Children with Severe Acute Respiratory Infections in Iran. Iran J Pediatr. 2018;28(1): e60948. [DOI: 10.5812/ijp.60948]
[19] Moattari A, Aleyasin S, Emami A, Fyruzi M, Pirbonyeh N. The Prevalence of Human Metapneumovirus and Respiratory Syncytial Virus and Coinfection with Both in Hospitalized Children with Acute Respiratory Infection in South of Iran. Arch Pediatr Infect Dis. 2015;3(3):e21581. [DOI: 10.5812/pedinfect. 21581v2]
[20] Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull World Health Organ. 2008;86(5):408-16. [DOI: 10.2471/blt.07. 048769] [PMID] [PMCID]
[21] Nathan AM, Rani F, Lee RJ, Zaki R, Westerhout C, Sam IC, et al. Clinical risk factors for life-threatening lower respiratory tract infections in children: a retrospective study in an urban city in Malaysia. PLoS One. 2014;9(10):e111162. [DOI: 10.1371/ journal.pone.0111162] [PMID] [PMCID]
[22] Velayatzadeh M. Air pollution sources in Ahvaz city from Iran. JAPH. 2020;5(2):147-152. [DOI: 10.18502/japh.v5i2.4243]
[23] Ghimire P, Gachhadar R, Piya N, Shrestha K, Shrestha K. Prevalence and factors associated with acute respiratory infection among under-five children in selected tertiary hospitals of Kathmandu Valley. PLoS One. 2022;17(4):e0265933. [DOI: 10.1371/journal. pone.0265933] [PMID] [PMCID]
[24] Falagas ME, Mourtzoukou EG, Vardakas KZ. Sex differences in the incidence and severity of respiratory tract infections. Respir Med. 2007;101(9):1845-63. [DOI: 10.1016/j.rmed.2007. 04.011] [PMID]
[25] Zheng HH, Xiang Y, Wang Y, Zhao QS, Fang R, Dai R. Clinical value of blood related indexes in the diagnosis of bacterial infectious pneumonia in children. Transl Pediatr. 2022;11(1): 114-119. [DOI: 10.21037/tp-21-568] [PMID]